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Q&A with Caldwell B. Esselstyn, Jr.

How does animal protein relate to your area of expertise, cardiovascular illness?
The guardian of all our blood vessels is a single layer of cells that lines all of our arteries, and that’s called the endothelium. The individual cell is the endothelial cell, and it makes a "magic" molecule that protects all of us, which is called nitric oxide. It’s a gas, and it has these remarkable properties. Animal protein injures the capacity of the endothelial cells to manufacture nitric oxide. Heart disease is now ubiquitous.

Does the traditional Western diet "guarantee" some form of disease in all of us?
When you have the combined devastation of dairy products and meat against this delicate endothelium, along with oil, the endothelium just doesn’t have a chance. Every time those foods pass your lips, you progressively injure your endothelium. So your level of protective nitric oxide with each decade is less and less and less and less.

What made you want to study this?
It was astounding for me to look at my family and my wife’s family and see the incredible amount disease that was disseminated throughout. I don’t think that we’re any different than any other families, who have so much cancer, diabetes, and cardiovascular disease.

Is fat something to be concerned about?
In my work, I never refer to low-fat or no fat; I talk about a plant-based diet. I treat vegans for heart disease. I treat vegetarians for heart disease. I never recommend those terms, because vegans eat French fries. Vegans eat oil. Vegans eat glazed donuts. That’s not the plant-based whole food diet that I’m talking about.

What are the biggest misconceptions about a healthy diet?
That olive oil is good. I don’t know how they get away with it saying that some oils are somehow good. Nothing is further from the truth. There’s also the absurdity of the milk mustache that you see on all these ads. When has any species ever continued to ingest dairy products beyond weaning? Especially dairy products from another species.

It’s going to take a brutal amount of education to overcome the tremendous amount of money that the dairy and meat industry have, to try to discredit their campaigns. When has the dairy industry or meat industry come out with their own studies reversing heart disease with their products?

How long does it take to start reversing heart disease once someone changes his diet?
When you take patients who are absolutely ravaged with heart disease and get them to stop ingesting any food that further injures their endothelium, the endothelium has this wonderful capacity to restore itself and raise the level of nitric acid. Lo and behold, not only do you arrest this disease, but you begin to reverse it.

It will depend upon the person’s genetics and severity of the disease, and the nature of the plaque itself. So, it’s almost impossible to have any solid rule about it. But we have seen reversals of chest pain, for instance, with its disappearance sometimes within 10 days to two weeks. Isn’t it exciting to think that some of these people can get rid of their pain literally within days of starting? Especially when you know that you’re doing this without a drug that has some hideous side effect. What’s so powerful about it is that you begin to recognize that you yourself have become the locus of control.

Can you talk about the importance of exercise?
I have had so many patients come to me who are athletes and runners and bikers and the like, and here they are, being pulled down to the side of the road by their heart disease. No matter how much they’re exercising, they’re eating all the wrong foods.

Do you recommend any so-called super foods, such as the acai berry and pomegranate?
Those are fine. But, you can just stick with blueberries and raspberries.

What do you think the future holds?
I really have a feeling that we are on the cusp of what could be a truly a seismic revolution in health. If you were to look where we are now, compared to where we were 25 years ago, it’s really quite striking how much more receptive are people to this kind of information.

Learn more about Dr. Esselstyn and his upcoming programs at Kripalu.